Endarterectomy Health Article

Definition

Endarterectomy is an operation to remove or bypass the fatty deposits, or blockage, in an artery narrowed by the buildup of fatty tissue (atherosclerosis).

Purpose

Removing the fatty deposits restores normal blood flow to the part of the body supplied by the artery. An endarterectomy is performed to treat cerebrovascular disease in which there is a serious reduction of blood supply to the brain (carotid endarterectomy), or to treat peripheral vascular disease (impaired blood supply to the legs).

Endarterectomy is most often performed on one of the two main arteries in the neck (the carotids) opening the narrowed arteries leading to the brain. When performed by an experienced surgeon, the practice is extremely effective, reducing the risk of stroke by up to 70%. Recent studies indicate it is effective in preventing stroke, even among those patients who had no warning signs except narrowed arteries detected by their doctors on a routine exam.

Precautions

Before the surgery, a full medical exam is usually done to assess any specific health problems, such as diabetes, high blood pressure, heart disease, or stroke. If possible, reversible health problems, such as cigarette smoking or being overweight, should be corrected.

Carotid artery disease

Every person has four carotid arteries (the internal and external carotids on each side of the neck) through which blood from the heart moves into the brain. If one of these arteries becomes blocked by fat and cholesterol, the patient may have a range of symptoms, including:

• weakness in one arm, leg, half of the face, or one entire side of the body
• numbness tingling
• paralysis of an arm, leg, or face
• slurred speech
• dizziness
• confusion, fainting, or coma
• stroke

Removing this fatty buildup, or bypassing a blocked segment, may restore blood flow to the brain, eliminate or decrease the symptoms, and lessen the risk of a stroke.

Peripheral vascular disease

When the blood vessels in the legs (and sometimes the arms) become narrowed, this can restrict blood flow and cause pain in the affected area. In severe cases, the tissue may die, requiring amputation.

The narrowing is usually caused by buildup of fatty plaques in the vessels, often as the result of smoking, high blood pressure, or poorly-controlled diabetes mellitus. The vessels usually narrow slowly, but it's possible for a blood clot to form quickly, causing sudden severe pain in the affected leg or arm.